Individual provider Active NPI

Kasra Taleb-Haghipoor

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1083354302
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5156 Issued in TN
Practice address
1265 Union Ave
4 Shorb Tower
Memphis, TN 38104
Phone
(901) 478-9183
Fax
(901) 478-8957
NPI assigned
Apr 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5156 TN Primary

Addresses

Primary practice location

1265 Union Ave
4 Shorb Tower
Memphis, TN 38104

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

1211 Union Ave Ste 300
Memphis, TN 38104-6655
Phone (901) 272-6018

Other practice location 2

6401 Poplar Ave Ste 540
Memphis, TN 38119-4823
Phone (901) 478-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126000529 TN Practitioner - Physician Assistant 7214308485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Methodist Physicians LLCGroup PAC ID 2769623669, 123 clinicians

Practice addresses (Care Compare)

1325 Eastmoreland Ave
Memphis, TN 38104-7542

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5156TNMDGeriatric Physical Therapist

Interoperability endpoints

  • Direct secure messaging: ktalebhaghipoor29000@mlh.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1083354302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "address_2": "4 SHORB TOWER",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38104",
            "telephone_number": "901-478-9183",
            "fax_number": "901-478-8957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Union Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381046655",
            "country_code": "US",
            "telephone_number": "901-272-6018",
            "fax_number": "901-201-4203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 Poplar Ave Ste 540",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194823",
            "country_code": "US",
            "telephone_number": "901-478-0900",
            "fax_number": "901-201-4203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALEB-HAGHIPOOR",
        "first_name": "KASRA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-05-07",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.